I feel a responsibility to speak about shields, as I have played a role in
making them a respectable tool to employ in CERTAIN SITUATIONS.  I want to
say that the new cut-out shields with the large teat cavity are not good
tools for the purposes I use shields for.  The teat cavity is so large that
the small, weak, or ill infant has great difficulty pulling up mom's nipple
inside this space.  Also due to the size, such infants have difficulty
getting jaw closure behind the shield on the breast where the sinuses are.
Consequently, they do latch (if they don't gag) but I think they just suck
on the empty tip.  I just saw the third baby this summer who has been
nursing off one of these shields and who is still down close to 10% weight
loss after a week at home. I do not see this effect from the newborn small
shields, which is the only size shield I use.  It is the baby's mouth, not
the mother's nipple size which is critical.  If mother has large nipples,
the shield may not be your best tool.  If she has large, FLAT nipples, I
stretch the base of the shield tissue to make it fit.  But I want a short
teat with a small cavity because these babies aren't strong enough to create
a lot of vacuum.  All you want is a tickle to the posterior palate to
trigger a suck response, this keeps baby willing to be at breast while you
fix the rest of the problems.  I keep hearing that other's like these
shields.  Tell me why, and report on their outcomes, please.  I think they
also slip off the nipple easily because of the cut out.  The full circle
shields stick on better and are less annoying.  I truly think this design
sounds like a good idea but isn't, and I say again, it isn't good enough to
be theoretical about therapeutic tools.  We have to watch our outcomes.  If
hospt. nurses are handing these out, are you bringing these babies back in
for weight checks every few days????

I'm concerned we'll have bad outcomes with these shields, which will throw
us back to the old days when shields had such a poor reputation because they
DID do harm.

Barbara

Barbara Wilson-Clay BSEd., IBCLC
Private Practice, Austin Texas
Visit the "LactNews-On-Line" Web Page
http://www.jump.net/~bwc/lactnews.html